Medial distal femur bone plate system

ABSTRACT

The current invention comprises a bone plate and method of use contoured to fit above the medial epicondyle that provides numerous apertures for fixation to the distal femur as desired with an offset screw design in shaft to allow location of screws around a nail or other feature and may also allow for attachment in conjunction with a lateral distal plate and or an extension plate that may cover the medial condyle.

CROSS-REFERENCE TO RELATED APPLICATIONS

Priority is claimed from provisional patent application U.S. Ser. No.61/957,196, filed on Jun. 26, 2013, and incorporated by referencedherein.

1. FIELD OF THE INVENTION

The present invention relates generally to surgical devices, system andmethod for internal fixation of fractures and non-unions of bones suchas the femur. More particularly, the present invention provides a boneplating system for distal femur fractures and non-unions generallyutilizing a specifically contoured bone plate or plates that fit to acorresponding specific portion or portions of the lower extremity of thefemur.

2. DESCRIPTION OF THE KNOWN PRIOR ART

As known, the femur is the only bone in the thigh of humans and is thelongest, heaviest and by most measures the strongest bone in the humanbody. The femur or thighbone is the most proximal bone of the leg intetrapod vertebrates capable of walking or jumping and is categorized asa long bone and comprises a diaphysis, the shaft or body and twoepiphyses that articulate with adjacent bones in the hip and knee. Thefemur is typically discussed as three general portions: the upper orproximal region, the middle portion referred to as the body or shaft,and the lower region often referred to as the distal femur, includingthe distal metaphysis and two condyles.

The lower extremity of the femur or distal extremity is larger than theupper extremity. It is somewhat cuboid in form, but its transversediameter is greater than its antero-posterior. It consists of two oblongeminences known as the condyles.

Anteriorly, the condyles are slightly prominent and are separated by asmooth shallow articular depression called the patellar trochlea.Posteriorly, they project considerably and a deep notch, theintercondylar fossa of femur, is present between them. The lateralcondyle is the more prominent and is the broader both in itsantero-posterior and transverse diameters. The medial condyle is thelonger and, when the femur is held with its body perpendicular, projectsto a lower level. When, however, the femur is in its natural obliqueposition the lower surfaces of the two condyles lie practically in thesame horizontal plane. The condyles are not quite parallel with oneanother; the long axis of the lateral is almost directlyantero-posterior, but that of the medial runs backward and medialward.Their opposed surfaces are small, rough, and concave, and form the wallsof the intercondyloid fossa. This fossa is limited above by a ridge, theintercondyloid line, and below by the central part of the posteriormargin of the patellar surface. The posterior cruciate ligament of theknee joint is attached to the lower and front part of the medial wall ofthe fossa and the anterior cruciate ligament to an impression on theupper and back part of its lateral wall.

The articular surface of the lower end of the femur occupies theanterior, inferior, and posterior surfaces of the condyles. Its frontpart is named the patellar trochlea and articulates with the patella. Itpresents a median groove, which extends downward to the intercondyloidfossa and two convexities, the lateral of which is broader, moreprominent, and extends farther upward than the medial.

Each condyle is surmounted by an elevation, the epicondyle. The medialepicondyle is a large convex eminence to which the tibial collateralligament of the knee joint is attached. At its upper part is theadductor tubercle and behind it is a rough impression, which givesorigin to the medial head of the gastrocnemius. The lateral epicondyle,which is smaller and less prominent than the medial, gives attachment tothe fibular collateral ligament of the knee-joint.

The knee is the largest weight-bearing joint in the body. The distalfemur makes up the top part of the knee joint. The upper part of theshinbone or tibia supports the bottom part of the knee joint. The endsof the femur are covered in a smooth, slippery substance calledarticular cartilage. This cartilage protects and cushions the bone whenbending and straightening the knee.

The body of the femur or shaft is long, slender and almost cylindricalin form and connects to the distal portion. It is a little broader abovethan in the center, broadest and somewhat flattened from before backwardbelow. It is slightly arched, so as to be convex in front, and concavebehind, where it is strengthened by a prominent longitudinal ridge, thelinea aspera that diverges proximal and distal as the medial and lateralridge.

Fractures of the thighbone that occur just above the knee joint arecalled distal femur fractures. The distal femur is where the bone flaresout like an upside-down funnel. Fractures of the distal femur mostcommonly occur in two patient types that being younger people typicallyconsidered under age 50 and the elderly.

Distal femur fractures in younger patients are usually caused byhigh-energy injuries, such as falls from significant heights or motorvehicle collisions. Because of the forceful nature of these fractures,many patients also have other injuries, often of the head, chest,abdomen, pelvis, spine, and other limbs.

Elderly people with distal femur fractures typically have poor bonequality. As we age, our bones get thinner. Bones can become very weakand fragile. A lower-force event, such as a fall from standing, cancause a distal femur fracture in an older person who has weak bones.Although these patients do not often have other injuries, they may haveconcerning medical problems, such as conditions of the heart, lungs, andkidneys, and diabetes.

Distal femur fractures vary. The bone can break straight across oftenreferred to as a transverse fracture or into many pieces often referredto as a comminuted fracture. Sometimes these fractures extend into theknee joint and separate the surface of the bone into a few or manyparts. These types of fractures are called intra-articular. Because theydamage the cartilage surface of the bone, intra-articular fractures canbe more difficult to treat.

Distal femur fractures can be closed, meaning the skin is intact, or canbe open. An open fracture is when a bone breaks in such a way that bonefragments stick out through the skin or a wound penetrates down to thebroken bone. Open fractures often involve much more damage to thesurrounding muscles, tendons, and ligaments. They have a higher risk forcomplications and take a longer time to heal.

When the distal femur breaks, both the hamstrings and quadriceps musclestend to contract and shorten. When this happens, the bone fragmentschange position and become difficult to line up with a cast.

It is known in distal humerus fractures to utilize medial and lateralcolumn plating. It is also known in proximal tibia fractures to utilizemedial and lateral column plating. However, distal femur fractures aretypically treated with just lateral plates. Lateral locking plates arewell established and generally have a good track record, but lateralplate failure is also well known.

When lateral locking plates fail, it is common to go varus or apexlateral angulation of the distal segment of a bone. Furthermore, lateralplates have no medial column support or buttress. When varus failureoccurs, medial buttress plating is often done and the current prior artoption is to bend a straight plate and hope it fits well.

Although numerous advancements have occurred in the field of bone platesin general, the prior art still has failed to bridge the gap between theneeds of medical professionals treating distal femur issues and the everincreasing demand. Therefore, an extensive opportunity for designadvancements and innovation remains for medial distal femur platedevices, systems, and methods where the prior art fails or is deficient.

SUMMARY OF THE INVENTION

In general, the present invention is a new and improved surgical device,system, and method which provides a bone plate for the treatment offractures and non-unions of femurs where the prior art fails. Thepresent invention generally provides a contoured plate or platesspecifically contoured to correspond with associated locations on themedial distal femur.

Without the intention of limitation, the invention may generallycomprise a plate or plates adapted to conform to the medial area of thedistal femur from generally near the medial epicondyle and generally upthe shaft of the femur. The plate may include numerous apertures forfixation to the distal femur as desired such as but not limited to anoffset screw design along the shaft to allow location of screws around anail or other feature. A preferred construction may allow for theplacement of screws through the plate into the shaft of the femur, theplacement of screws through the plate generally into the lateralcondyle, the placement of screws through the plate generally into themedial condyle and so forth. It is understood that the current inventionmay allow for fixation for multiple sites. The medial distal plate maybe used in conjunction with a lateral distal plate. It is furthercontemplated to provide an extension plate to generally cover the medialcondyle.

Furthermore, the invention may include a method for utilizing a medialdistal plate such as but not limited to making an incision approximately15cm from the knee joint proximally. Deep fascia may be split in linewith the skin incision and may include saphenous vein and nerveretracted either anteriorly or posteriorly. Vastus medialis may bedissected off of the intermuscular or IM septum. Subperiostealdissection may expose distal femur and to be noted is that the femoralvessels may be safely out of the fixation zone.

In this respect, before explaining at least one embodiment of theinvention in detail, it is to be understood that the invention is notlimited in this application to the details of construction and to thearrangement of the components set forth in the following description orillustrated in the drawings. The invention is capable of otherembodiments and of being practiced and carried out in various ways.Also, it is to be understood that the phraseology and terminologyemployed herein are for the purpose of description and should not beregarded as limiting. As such, those skilled in the art will appreciatethat the conception, upon which this disclosure is based, may readily beutilized as a basis for the designing of other structures, methods andsystems for carrying out the several purposes of the present invention.It is important, therefore that the claims be regarded as including suchequivalent constructions insofar as they do not depart from the spiritand scope of the present invention.

Accordingly, titles, headings, chapter names, classifications andoverall segmentation of the application in general should not beconstrued as limiting. Such are provided for overall readability and notnecessarily as literally defining text or material associated therewith.

Further, the purpose of the foregoing abstract is to enable the U.S.Patent and Trademark Office and the public generally, and especially thescientist, engineers and practitioners in the art who are not familiarwith patent or legal terms or phraseology, to determine quickly from acursory inspection the nature and essence of the technical disclosure ofthe application. The abstract is neither intended to define theinvention of the application, which is measured by the claims, nor is itintended to be limiting as to the scope of the invention in any way.

It is therefore an object of the present invention to provide a new andimproved medial distal femur bone plate devices, system and method ofusing the same that provides greater ease of use, patient comfort, andfunction to a wide range of uses associated with the fractures andnon-unions.

It is a further object of the present invention to provide a new andimproved medial distal femur bone plate devices, system and method ofusing the same, which is of a robust design, as well as be easily andefficiently manufactured.

An even further object of the present invention is to provide a new andimproved medial distal femur bone plate devices, system and method ofusing the same, which is of a more durable and reliable constructionthan that of the existing known art.

Still another object to the present invention is to provide a new andimproved medial distal femur bone plate devices, system and method ofusing the same, which is susceptible of a low cost of manufacture withregard to both materials and labor, which accordingly is thensusceptible of competitive prices of sale to the public, thereby makingsuch economically available to those in need.

Another object of the present invention is to provide a new and improvedmedial distal femur bone plate devices, system and method of using thesame, which provides some of the advantages of the prior art, whilesimultaneously overcoming some of the disadvantages normally associatedtherewith.

Yet another object of the present invention is to provide a new andimproved medial distal femur bone plate devices, system and method ofusing the same that provides multiple fixation options as well asmultiple treatment location options.

Still further, it is an object of the present invention to provide a newand improved medial distal femur bone plate devices, system and methodof using the same that will allow the medical professional to alwayshave a readily available bone plate system that allows a surgeon toplate around previously inserted objects such as but not limited tointramedullary nail, total knee arthroplasty and so forth.

It is a further object of the present invention to provide a new andimproved medial distal femur bone plate devices, system and method ofusing the same that may be used in conjunction with a lateral distalfemur plate and other medial lateral plates.

These together with other objects of the invention, along with thevarious features of novelty, which characterize the invention, arepointed out with particularity in the claims annexed to and forming apart of this disclosure. For a better understanding of the invention,its operating advantages and the specific objects attained by its uses,reference would be had to the accompanying drawings and descriptivematter in which there are illustrated preferred embodiments of theinvention.

BRIEF DESCRIPTION OF THE DRAWINGS AND PICTORIAL ILLUSTRATIONS

The invention will be better understood and objects other than those setforth above will become apparent when consideration is given to thefollowing detailed description thereof. Such description makes referenceto the annexed pictorial illustrations, graphs, drawings, andappendices.

FIG. 1 is a general top view depiction of a preferred embodiment of theinvention attached to a femur.

FIG. 2 is a general side view depiction of a preferred embodiment of theinvention attached to a femur.

FIG. 3 is a general side view depiction of a preferred embodiment of theinvention attached to a femur and also generally depicting a distallateral plate.

FIG. 4 is a general depiction of a method for making and locating anincision in accordance with a preferred embodiment of the invention

FIG. 5 is a general side view depiction of a preferred embodiment of theinvention.

FIG. 6 is a general top view depiction of a preferred embodiment of theinvention.

FIG. 7 is another general top view depiction of a preferred embodimentof the invention.

FIG. 8 is another general side view depiction of a preferred embodimentof the invention attached to a femur.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring now to the drawings, wherein like reference numerals designatecorresponding structure throughout the views, and referring inparticular to FIG. 1, reference numeral 10 generally refers to a new andimproved medial distal femur bone plate devices, system and method ofusing the same hereinafter referred to as “invention 10” or “invention”,in accordance with a preferred embodiment of the current invention.

Invention 10 generally contemplates, as discussed further below, apre-contoured plate designed for fixation of the femur shaft and distalfemur that is applied to the medial side of the femur. The plate mayinclude holes that may have threads and a shape to accommodate lockingscrews, non-locking screws, cables, pins, trochars, guides, buttons, andor extensions that may be located along the entire length of the plate.Invention 10 contemplates additional holes of varying sizes and shapesalong the plate for accommodating other bone fixation devices such aswires, pins, buttons, cables, extensions, guides, and so forth. Thedistal portion of the plate may match the shape of the medial portion ofthe medial condyle. The screw holes along the distal portion of theplate may be designed to accommodate screws for fixation of the distalfemur, including the medial condyle, lateral condyle, intercondylartrochlea, and metaphyseal portion of the femur. The shaft portion of theplate may be essentially straight in the coronal plane with a slightcurve in the sagittal plane to match the natural sagittal curve of thefemur shaft.

The screw holes along the shaft portion of the plate may accommodatescrews for affixing the plate to the medial femur shaft and/or forfixation of fractures extending proximal to the distal femur along theshaft of the femur. There may be a transitional portion of the platethat will curve between the shaft portion and the distal portion. Thecurve of this transitional zone may contour to the distal medialmetaphyseal portion of the femur. There may be screw holes or otherholes placed along this transitional zone of the plate.

More in particular, invention 10 may generally include plate 20 having afirst end 30, a shaft and or middle 40, a second end 50, a top surface60, a bottom surface 70, a width 80, a length 90, and a thickness 100.It is understood that plate 20 may have many configurations, shapes,sizes and so forth and the current invention should not be consideredlimited to the illustrations. It is also contemplated that first end 30may include a flared portion 35 generally making first end 30 wider thansecond end 50 and middle 40. The illustrations generally depict apreferred embodiment and it is understood that numerous otherembodiments are contemplated.

Referring to the illustration and more in particular to FIG. 6, in apreferred embodiment length 90 may be about 15 centimeters. It isunderstood that length 90 may be shorter or longer. In a preferredembodiment, width 80 may be about 18 mm around second end 50 and ormiddle 40 and 35 mm around first end 30 and flare 35. It is alsounderstood that width 80 may be shorter or longer. In a preferredembodiment, thickness 100 may be about 5 mm. It is understood thatthickness 100 may be greater or lesser. It is also understood that plate20 may be generally sized to generally adapt for larger people, smallerpeople, and so forth and contoured accordingly. Invention 10 may includea surgery kit with numerous sizes of bone plate 20 as desired fortreating individuals.

Invention 10 may include numerous holes or aperture 110 as will bediscussed further below. It is also understood that invention 10 mayutilize bone anchors 120 such as but not limited to known cannulatedlocking screws as indicated for certain types of fractures andnon-unions of the proximal femur. Invention 10 may also utilize otherbone anchors 120 such as non-cannulated non-locking screws,non-cannulated locking screws, variable angle locking screws, fixedangle nails, pins, blades, cables, wires and combination thereof. It isalso understood that bone anchors 120 generally cooperate with plate 20apertures 110 to secure the various bone anchor 120 to the femur 130 aswill also be discussed in greater detail below.

Again referring to the illustration and more in particular to FIG. 7,invention 10 contemplates utilizing scalloped edges 105. It iscontemplated that plate 20 may have a configuration wherein irregularedges may be included such that a flare is created out around the holes110. It is understood that numerous configurations of scalloped edges105 are contemplated and the illustration should not be considered tolimit invention 10 to the depicted.

Bone plate 20 may be made from metal such as but not limited tostainless steel, titanium, composite materials, combinations thereof,and so forth. It is understood that plate 20 may be made of othermaterials other than metal. Bone anchors 120 are known in the art andmay be of numerous materials.

Referring to the illustration in general and more in particular to FIG.2, It is understood that femur 130 has a distal end 140, a medialepicondyle 150, a medial condyle 155, a lateral epicondyle 160, alateral condyle 165, a medial aspect or side 170, a lateral aspect orside 180, an anterior aspect or side 190, a posterior aspect or side200, adductor magnus tubercle 205, a patellar surface 210, intercondylartrochlear region 215, main body or shaft 220, metaphyseal bone portion225 and so forth.

It is understood that the articular surface 227 of the lower or distalend 140 femur 130 occupies the anterior, inferior, and posteriorsurfaces of the condyles. Its front part is named the patellar surface210 and articulates with the patella.

Invention 10 contemplates plate 20 bottom surface 70, thickness 100, andor top surface 60 are generally contoured to adapt to femur 130 distalend 140 medial aspect 170. Bottom surface 70 may be generally curved asdepicted although invention 10 contemplates numerous contouring and orcurvature.

Invention 10 contemplates plate 20 generally to be positioned such thatfirst end 30 does not extend past medial condyle 155, but rather ends onor about medial epicondyle 150, articular surface 227 of medial condyle155 and or adductor magnus tubercle 205 as generally depicted. It isalso contemplated that plate 20 may extend past the aforementioned.Second end 50 may generally be positioned on shaft 220 of femur 130 andmay have a varying length 90. Plate 20 second end 50 may generally bepositioned along femur 130 shaft 220 and be limited in length 90 andgenerally positioning by the vascular structures crossing the medialaspect 170 femur 130 from anterior aspect 190 to posterior aspect 200such as femoral artery and or femoral vein. It is also contemplated thatlength 90 of bone plate 20 generally may be the same as the lengthbetween shaft 220 and same medial epicondyle 150 of femur 130 in apreferred construction.

Plate 20 may extend posteriorly to the level of the adductor magnustubercle 205 and posterior aspect 200 to femur 130 shaft 220. Plate 20may also extend anteriorly to the anterior-medial portion of femur 130shaft 220 and medial and anterior-medial facet of the medial condyle 155and medial epicondyle 150.

The present invention 10 contemplates providing plate 20 with apertures110A, 110B, 110C, and 110D for generally positioning bone anchors 120A,120B, 120C, and 120D generally anterior aspect 190 and on shaft 220. Thepresent invention 10 also contemplates providing plate 20 with apertures110E, 110F, 110G, and 110H for generally positioning bone anchors 120E,120F, 120G, and 120H generally posterior aspect 200 on shaft 220. It isfurther contemplated these bone anchors 120 are generally perpendicularto plate 20. Although it is understood that closer to the medialepicondyle 150 the angle may change more so and the bone anchors 120 mayengage the region below the area known commonly as the shaft 220 such asbut not limited to medial condyle 155, lateral condyle 165, and soforth.

Holes or apertures 110 may be threaded, angled, and so forth tocooperate with bone anchors 120. A preferred embodiment may be wherebone anchors 120 head finish generally flush with bone plate 20 topsurface 60. By example, holes or apertures 110 may further include arecessed portion for providing a screw head to finish flush generallyinside bone plate 20.

Referring to the illustration and more in particular to FIGS. 2 and 5,it is understood that plate 20 has generally an angle or curve 230wherein plate 20 first end 30 is generally flush along femur 130corresponding angle or curve 240 and generally positioned above themedial epicondyle 150. Curve 230 may be generally angled as defined asangle 260 between Line AA which may generally lay along and parallelwith plate 20 bottom surface 70 at second end 50 and Line BB, which maygenerally lay along and parallel with first end 30. Angle 260 maygenerally be 20 degrees although it is contemplated that angle 260 maybe greater or smaller.

Still further, invention 10 contemplates utilizing plate 20 withapertures 110I, 110J, 110K, 110L, 110M, and 110N for generallypositioning bone anchors 120I, 120J, 120K, 120L, 120M, and 120N alongplate 20 curve 230. These bone anchors 120 may generally be longer suchthat they engage the medial condyle 155 and lateral condyle 165.

It is contemplated that bone anchors 120 may generally be placed alongplate 20 first end 30, shaft and or middle 40, second end 50. It isfurther contemplated that bone anchors 120 such as but not limited toscrews generally positioned on first end 30 plate 20 angle or curve 230may be pointed in such a trajectory as to gain fixation in the medialcondyle 155, lateral condyle 165, intercondylar trochlear region 215,and/or the metaphyseal bone 225 of the distal end 140 femur 130.

Bone anchors 120 may be directed around previously-placed hardware suchas the femoral component of total knee arthroplasty, intramedullaryimplants, plates, screws, or other implanted hardware. In a preferredembodiment, bone anchors 120 may be positioned with plate 20 such thatbone anchors 120 do not touch.

Referring to the illustrations again and more in particular to FIG. 3,in a preferred embodiment, invention 10 may include use of a lateralplate 250. It is understood that lateral plate 250 may be of a similarconstruction as plate 20 but corresponding to the lateral distal femuraccordingly.

Once again referring to the illustrations and more in particular to FIG.8, in a preferred construction, invention 10 may utilize an extensionplate 270 that generally covers medial condyle 155 and may or may notabut plate 20 first end 30. It is contemplated that extension plate 270may include apertures 110 for bone anchors 120.

Once again referring to the drawings in general and more specifically toFIG. 4, invention 10 may include a method for utilizing a medial distalplate 20 such as but not limited to making an incision approximately15cm from the knee joint proximally. Deep fascia may be split in linewith the skin incision and may include saphenous vein and nerveretracted posteriorly. Vastus medialis may be dissected off of theintermuscular or IM septum. Subperiosteal dissection may expose distalfemur 130 and to be noted is that the femoral vessels may be safely outof the fixation zone.

Invention 10 may be utilized for the direct fixation of the medialaspect 170 distal end 140 of femur 130 and medial aspect 170 femur 130shaft 220, primary fixation of distal end 140 femur 130 fractures,primary fixation of femur 130 shaft 220 fractures, secondary (adjunct)fixation of distal end 140 femur 130 or femur 130 shaft 220 fractures inaddition to intramedullary or lateral-based fixation, and so forth.Invention 10 may also be utilized with periprosthetic fracturesincluding but not limited to above the femoral component of total kneearthroplasty, at the distal end of intramedullary implant in femur 130,above or below previously-placed femoral hardware, and so forth. It isalso contemplated to be utilized with an out rigger as known in art forpercutaneous fixation.

Possible indications may be primary fractures of femur 130 shaft 220 ordistal end 140 femur 130, peri-prosthetic fractures of femur 130 shaft220 or distal end 140 femur 130, non-united fractures of femur 130 shaft220 and or distal end 140 femur 130 requiring primary or secondarymedial aspect 170 fixation, and so forth.

It is therefore contemplated invention 10 may provide bone plate 20 fortreating fractures and non-unions of distal femur 130 said femur 130having shaft 220 with medial aspect 170, medial epicondyle 150, and alength defined as the distance between said shaft 220 with medial aspect170 and said medial epicondyle 150 and wherein said length has curve240; said bone plate 20 comprising top surface 60, bottom surface 70 forcontacting said femur 130; one or more apertures 110 wherein said one ormore apertures 110 pass through said top surface 60 and said bottomsurface 70 and are configured to fix a bone anchor 120 through said topsurface 60 and said bottom surface 70 to attach said bone plate 20 tosaid femur 130; first end 30 for attaching to said medial epicondyle150; second end 50 for attaching to said shaft 220 with medial aspect170; length 90 defined as the distance between said first end 30 andsaid second end 60 and said length 90 having curve 230 wherein saidlength 90 generally matches said length on said femur 130 and whereinsaid curve 230 generally matches said curve 240 of said length on saidfemur 130.

Accordingly, other implementations are within the scope of the followingclaims. Changes may be made in the combinations, operations, andarrangements of the various parts and elements described herein withoutdeparting from the spirit and scope of the invention.

I claim:
 1. A bone plate for treating fractures and non-unions of adistal femur said femur having a shaft with a medial aspect, a medialepicondyle, and a length defined as the distance between said shaft witha medial aspect and said medial epicondyle and wherein said length has acurve, said bone plate comprising; a top surface; a bottom surface forcontacting said femur; one or more apertures wherein said one or moreapertures pass through said top surface and said bottom surface and areconfigured to fix a bone anchor through said top surface and said bottomsurface to attach said bone plate to said femur; a first end forattaching to said medial epicondyle; a second end for attaching to saidshaft with a medial aspect; and a length defined as the distance betweensaid first end and said second end and said length having a curvewherein said length generally matches said length on said femur andwherein said curve generally matches said curve of said length on saidfemur.
 2. The bone plate of claim 1 wherein said length of said boneplate is about 15 centimeters.
 3. The bone plate of claim 1 wherein saidlength of said bone plate is less than 15 centimeters.
 4. The bone plateof claim 1 wherein said length of said bone plate is greater than 15centimeters.
 5. The bone plate of claim 1 wherein said bone plate ismade from titanium.
 6. The bone plate of claim 1 wherein said bone plateis made from stainless steel.
 7. The bone plate of claim 1 wherein saidcurve of said bone plate is about 20 degrees.
 8. The bone plate of claim1 wherein said curve of said bone plate is less than 20 degrees.
 9. Thebone plate of claim 1 wherein said curve of said bone plate is more than20 degrees.
 10. The bone plate of claim 1 wherein said top surface is ata distance of about 5 millimeters from said bottom surface.
 11. The boneplate of claim 1 wherein said top surface is at a distance of greaterthan 5 millimeters from said bottom surface.
 12. The bone plate of claim1 wherein said top surface is at a distance of less than 5 millimetersfrom said bottom surface.
 13. The bone plate of claim 1 wherein saidfirst end has a width of about 35 millimeters.
 14. The bone plate ofclaim 1 wherein said first end has a width of greater than 35millimeters.
 15. The bone plate of claim 1 wherein said first end has awidth of less than 35 millimeters.
 16. The bone plate of claim 1 whereinsaid second end has a width of about 18 millimeters.
 17. The bone plateof claim 1 wherein said second end has a width of less than 18millimeters.
 18. The bone plate of claim 1 wherein said second end has awidth of greater than 18 millimeters.